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Everad F, Seifert L, Mansour N, Hofauer B, Knopf A, Offergeld C. [Virtual training of practical competences in sonography]. HNO 2024; 72:350-356. [PMID: 38587663 PMCID: PMC11045615 DOI: 10.1007/s00106-024-01476-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE During the COVID-19 pandemic, a particular challenge in the transition to digital teaching was to teach practical skills such as sonography of the head and neck online. The aim of this study was to validate the digital sonography course for medical students established at the Freiburg University Hospital ENT Department. METHODS Participants were 178 students of human medicine. The study group simulated the sonography examination at home with a dummy transducer using the Peyton method under the guidance of a tutor via video seminar. In a subsequent learning success check, the results of the students in the online course were compared with those of the control group, who learned sonography in the classroom. RESULTS Students of the online course achieved comparable results to the classroom group. CONCLUSION This study shows that practical skills which require extensive equipment such as a sonography machine can be taught to a certain extent digitally or at least in a hybrid form.
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Affiliation(s)
- F Everad
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
| | - L Seifert
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Mansour
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - B Hofauer
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde Innsbruck, Innsbruck, Österreich
| | - A Knopf
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - C Offergeld
- Klinik für Hals- Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
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Schmit C, Runge A, Jöbstl A, Widmann G, Schmutzhard J, Hofauer B. [Sudden-onset double vision-a complication requiring interdisciplinary treatment]. HNO 2024:10.1007/s00106-024-01450-x. [PMID: 38498175 DOI: 10.1007/s00106-024-01450-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/20/2024]
Affiliation(s)
- C Schmit
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
| | - A Runge
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - A Jöbstl
- Universitätsklinik für Radiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - G Widmann
- Universitätsklinik für Radiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - J Schmutzhard
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
| | - B Hofauer
- Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich
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Offergeld C, Hofauer B, Poxleitner P, Lagrèze W, Schnell O, Petersen N, Lang F, Burkhardt V, Pfeiffer J, Albrecht T. [Traumatology-an interdisciplinary task: exclusively for educational purposes?]. HNO 2023; 71:8-14. [PMID: 36525032 PMCID: PMC9839790 DOI: 10.1007/s00106-022-01255-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Traumatology of the head and neck region is not only a part of otorhinolaryngology, but also has a large overlap with neighboring disciplines of the head and neck region. In Freiburg, an interdisciplinary lecture on "ENT emergencies" was implemented in the 21/22 winter semester. The aim was to provide an even more realistic view on interdisciplinary patient care and to make evident the areas of intersection of four of the major head disciplines (otorhinolaryngology, neurosurgery, ophthalmology, and maxillofacial surgery). MATERIALS AND METHODS A new, special lecture in otorhinolaryngology was implemented as part of the regular online lecture series accompanying the semester. With reference to the clinical care of ENT emergencies, possible overlaps with neighboring disciplines were identified and explained by the discipline representatives or discussed in front of and with the auditorium. At the end of the semester, all participating students (n = 173) were invited to evaluate the seminar using the survey tool "EvaSys" (EvaSys GmbH, Lüneburg, Germany). In total, 78 students participated in the evaluation process. RESULTS The new lecture concept was very well accepted and immediately ranked top among the interdisciplinary lecture titles within the ENT lecture series. The clear communication of the term "interdisciplinarity" in the sense of a complementary clinical cooperation was also very successful and was appreciated accordingly by students during the evaluation process. CONCLUSION Pragmatic presentation of ideal clinical patient care using an interdisciplinary approach is possible within the regular ENT lecture series. This realistic portrayal, beyond any technical and/or professional differences, is of great interest to students and is considered clinically relevant. Thus, interdisciplinary lectures provide a valuable tool to teach the fundamental values of clinical interdisciplinary management for the best possible patient care.
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Affiliation(s)
- C Offergeld
- Univ.-HNO-Klinik, Medizinische Fakultät, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - B Hofauer
- Univ.-HNO-Klinik, Universitätsklinikum TUM München, München, Deutschland
| | - P Poxleitner
- Univ.-Klinik für MKG-Chirurgie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - W Lagrèze
- Univ.-Augenklinik, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - O Schnell
- Neurochirurgische Univ.-Klinik, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - N Petersen
- Studiendekanat, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - F Lang
- Univ.-HNO-Klinik, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - V Burkhardt
- Univ.-HNO-Klinik, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Pfeiffer
- HNO-Praxis am Theater, Freiburg, Deutschland
| | - T Albrecht
- Univ.-HNO-Klinik, Universitätsklinikum Tübingen, Tübingen, Deutschland
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Hofauer B, Johnson F, Zhu Z. AB0469 EVALUATION OF SALIVARY GLAND ALTERATIONS IN SJÖGREN’S SYNDROME WITH MULTISPECTRAL OPTOACOUSTIC TOMOGRAPHY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMore than half of all patients with Sjögren’s syndrome (SjS) show characteristic sonomorphological changes in the salivary glands. The relevance of this alterations for diagnosis and follow-up has been investigated in multiple studies. However, it is still not known which parenchymal changes cause this sonomorphological picture. Multispectral optoacoustic tomography (MSOT) is based on the photoacoustic effect – by exciting different chromophores with lasers of different wavelengths, information on tissue composition can be generated. With the help of MSOT, knowledge about tissue changes in salivary glands in patients with SjS should be gained for the first time.ObjectivesCan MSOT be applied in the area of the salivary glands and provide new information on the parenchymal changes in SjS?MethodsIn patients with SjS, classified according to the ACR/EULAR classification criteria, the ESSPRI and ESSDAI were recorded and tear flow and unstimulated salivary flow were determined. The sonomorphological changes in the salivary glands were evaluated using the OMERACT scoring system. Using MSOT, collagen, lipids and (de)oxygenated hemoglobin of the parotid and submandibular glands on both sides were measured (MSOT Acuity Echo).ResultsTwenty-three patients were included in the study (21 women, age: 62 years). At the time of the study, the ESSPRI averaged 47 points and the ESSDAI 8.5 points. The Schirmer test gave an average value of 6.4 mm/5 min, the unstimulated salivary flow (UWSF) 0.2 ml/5 min. The evaluation of the B-mode sonography showed predominantly hypoechoic lesions and less hyperechoic bands. In the evaluation of the tissue information obtained by means of MSOT, a correlation between increased lipid content and salivary flow measurement was shown as well as a significant difference between collagen proportion between parotid and submandibular glands.ConclusionWith the help of MSOT, statements about the actual tissue changes within the salivary glands in SjS can be made for the first time. This project demonstrated for the first time a correlation between tissue composition and clinical parameter. The evaluation of other wavelengths in order to obtain further information on the tissue composition is planned.Disclosure of InterestsNone declared
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Mansour N, Backes C, Becker C, Hofauer B, Knopf A. [Clear resection margins to avoid escalation of adjuvant therapy in oropharyngeal squamous cell carcinoma]. HNO 2021; 69:256-262. [PMID: 32975607 PMCID: PMC7997822 DOI: 10.1007/s00106-020-00932-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Resection margins in patients with oropharyngeal squamous cell carcinoma (OPSCC) are a predictive marker for overall survival (OS) and recurrence-free interval (RFI). Adjuvant therapy is influenced by TNM status, extracapsular extension (ECE), and resection margin status (R) of the primary tumor. The R status can be directly influenced by the head and neck surgeon. The aim of the current study was to evaluate the impact of R status on treatment decisions, RFI, and OS. MATERIALS AND METHODS All patients with OPSCC who underwent surgery (with/without adjuvant therapy) between 2001 and 2011 were enrolled. Clinical data, survival parameters, histologic data such as ECE, resection margin status, and tumor size were retrospectively collected and analyzed. RESULTS A total of 208 patients were enrolled. Survival parameters showed that patients with microscopically clear (R0) resection margins had an RFI/OS of 89/87 months. These values decreased in patients with R1 (65/65 months), R2 (38/33 months), and Rx (unclear) resections (59/45 months; p = 0.036/p = 0.001). In patients with ECE and R1 resection, but also in those with R0 resections achieved by follow-up resection and those with Rx resections, adjuvant therapy was escalated. CONCLUSION Unclear resection status reduces OS and RFI in patients with OPSCC. Therefore, in surgical therapy, clear resection status in the first pass should be strived for to avoid escalation of adjuvant therapy due to an unclear R status.
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Affiliation(s)
- N Mansour
- Klinik für Hals, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
| | - C Backes
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - C Becker
- Klinik für Hals, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - B Hofauer
- Klinik für Hals, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - A Knopf
- Klinik für Hals, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
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Graf S, Kirschstein L, Knopf A, Mansour N, Jeleff-Wölfler O, Buchberger AMS, Hofauer B. Systematic evaluation of laryngeal impairment in Sjögren's syndrome. Eur Arch Otorhinolaryngol 2021; 278:2421-2428. [PMID: 33765165 PMCID: PMC8165056 DOI: 10.1007/s00405-021-06746-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/10/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Sjögren's syndrome (SjS) causes malfunction of the salivary and lacrimal glands. Consequently, patients suffer from xerostomia and keratoconjunctivitis sicca. This can further affect the voice and swallowing function resulting in an impaired quality of life. Aim of this study is the systematic evaluation of the impact on voice and swallowing-related quality of life in patients with SjS. MATERIAL AND METHODS SjS patients were classified according to the American-European Consensus Group (AECG) criteria; antibodies to Ro (SS-A) or La (SS-B) antigens were detected, ESSPRI was completed. We used the following quality of life questionnaires: EORTC QLQ H&N 35, Anderson Dysphagia Inventory (ADI) and Voice Handicap Index (VHI). Patients additionally received a detailed phoniatric examination (auditory perception, videostroboscopy, acoustic analysis, Dysphonia Severity Index (DSI), aerodynamics measurements). RESULTS Almost all the 54 patients (96.3%) had a limited quality of life due to their swallowing problems and 48% due to their voice problems. Both values correlated significantly with the degree of xerostomia. In the phoniatric examination, 77.8% had an increased DSI and two-thirds had abnormalities in videostroboscopy. CONCLUSIONS A reasonable impairment of quality of life in patients with SjS due to the limitations in voice and swallowing function was observed. As SjS does not limitate life expectancy, preservation of quality of life is important. Detection of voice and swallowing problems as potential reasons for quality of life impairment should be detected and, if diagnosed, treated accordingly.
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Affiliation(s)
- S Graf
- Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany.
| | - L Kirschstein
- Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - A Knopf
- Otorhinolaryngology/Head and Neck Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - N Mansour
- Otorhinolaryngology/Head and Neck Surgery, University Medical Center Freiburg, University of Freiburg, Freiburg im Breisgau, Germany
| | - O Jeleff-Wölfler
- Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - A M S Buchberger
- Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
| | - B Hofauer
- Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany
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Hofauer B, Mansour N, Becker C, Ketterer MC, Knopf A. [Functional outcomes after surgical treatment of oropharyngeal carcinomas]. HNO 2021; 69:95-100. [PMID: 32430667 DOI: 10.1007/s00106-020-00887-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The primary goal of surgical resection of oropharyngeal carcinoma (OPSCC) is an R0 resection. The extension of the primary tumor is decisive for selection of access route, which should be as circumscribed as possible but as radical as necessary. To date, there are no prospective comparative studies that compared functional outcome in terms of surgical access route. MATERIALS AND METHODS A selective literature search was carried out for the period from 01/01/2000 to 12/31/2019 to assess the functional result after different surgical approaches in the treatment of OPSCC. The search strategy aimed to identify publications that investigated the functional result of transoral approaches, robot-assisted transoral resections (TORS), and surgical resection using pharyngotomies or transmandibular approaches. RESULTS Various measures were identified which enable subjective and objective assessment of swallowing and speaking restrictions. For all surgical access routes, studies were identified that examined the functional aspects of the respective access, but there are no direct comparisons between the individual approaches. CONCLUSION There are various surgical approaches available for resection of OPSCC, each of which has been examined in various studies with regard to its oncological and functional results.
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Affiliation(s)
- B Hofauer
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
| | - N Mansour
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - C Becker
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - M C Ketterer
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
| | - A Knopf
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland
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Offergeld C, Ketterer M, Neudert M, Hassepaß F, Weerda N, Richter B, Traser L, Becker C, Deeg N, Knopf A, Wesarg T, Rauch AK, Jakob T, Ferver F, Lang F, Vielsmeier V, Hackenberg S, Diensthuber M, Praetorius M, Hofauer B, Mansour N, Kuhn S, Hildenbrand T. ["Online from tomorrow on please": comparison of digital framework conditions of curricular teaching at national university ENT clinics in times of COVID-19 : Digital teaching at national university ENT clinics]. HNO 2020; 69:213-220. [PMID: 32929523 PMCID: PMC7490113 DOI: 10.1007/s00106-020-00939-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
Hintergrund Die Corona-Krise beeinflusst nicht nur das professionelle Handeln, sondern auch die Lehre an den Universitäten. Schlagworte wie „E-Learning“ und „Digitalisierung“ suggerieren die Möglichkeit innovativer, ad hoc verfügbarer Lösungsansätze für die Lehre in der aktuellen COVID-19-Situation. Die aktuelle Umstellung auf digitale Lehre ist aber nicht primär durch eine didaktische Sinnhaftigkeit oder institutionelle Strategie, sondern durch äußere Notwendigkeit geprägt. Ziel der Arbeit Ziel der Arbeit war die Erfassung der Lehrsituation an nationalen Universitäts-HNO-Kliniken und akademischen Lehrkrankenhäusern zu Beginn des virtuellen Corona-Sommersemesters 2020. Material und Methode Ein eigens erstellter Fragebogen zur jeweiligen lokalen Situation, den örtlichen Rahmenbedingungen sowie zu bundesweiten Szenarien wurde an alle 39 nationalen Universitäts-HNO-Kliniken und 20 akademischen Lehrkrankenhäuser mit HNO-Hauptabteilung versandt. Ergebnisse Die ausgefüllten Fragebögen von 31 Universitätskliniken (UK) und 10 akademische Lehrkrankenhäuser (ALK) gingen in die Auswertung ein. Es zeigten sich offensichtliche Diskrepanzen zwischen verfügbaren Ressourcen und tatsächlich verfügbaren digitalisierten Lehrinhalten. Weitere Kritikpunkte offenbarten sich in Bezug auf die Kommunikation mit der Medizinischen Fakultät, die digitale Infrastruktur und insbesondere in der oftmals mangelnden Kollaboration mit den zentralen Supportstrukturen, wie Medien‑, Didaktik- und Rechenzentren. Schlussfolgerung Es gibt durchaus positive Beispiele für eine gelungene Überführung der Präsenzlehre in das ausschließlich virtuelle Sommersemester 2020 innerhalb der Universitäts-HNO-Kliniken. Mehrheitlich aber überwiegen kritische Einschätzungen der Lehrbeauftragten bzw. Ärztlichen Direktoren gegenüber der aktuellen Lehrsituation. Eine zeitkritische strategische Weiterentwicklung ist dringend erforderlich.
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Affiliation(s)
- C Offergeld
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland.
| | - M Ketterer
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - M Neudert
- Univ.-HNO-Klinik, Med. Fakultät, Technische Universität Dresden, Dresden, Deutschland
| | - F Hassepaß
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Weerda
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - B Richter
- Institut für Musikermedizin, Med. Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - L Traser
- Institut für Musikermedizin, Med. Fakultät, Albert-Ludwigs-Universität, Freiburg, Deutschland
| | - C Becker
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Deeg
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - A Knopf
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Wesarg
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - A-K Rauch
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - T Jakob
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - F Ferver
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - F Lang
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - V Vielsmeier
- Univ.-HNO-Klinik, Med. Fakultät, Universität Regensburg, Regensburg, Deutschland
| | - S Hackenberg
- Univ.-HNO-Klinik, Med. Fakultät, Julius-Maximilians-Universität, Würzburg, Deutschland
| | - M Diensthuber
- Univ.-HNO-Klinik, Med. Fakultät, , Goethe Universität, Frankfurt/M, Deutschland
| | - M Praetorius
- Univ.-HNO-Klinik, Med. Fakultät, Ruprecht-Karls-Universität, Heidelberg, Deutschland
| | - B Hofauer
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - N Mansour
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
| | - S Kuhn
- Zentrum für Orthopädie und Unfallchirurgie, Universitätsmedizin, Johannes Gutenberg-Universität, Mainz, Deutschland
| | - T Hildenbrand
- Univ.-HNO-Klinik, Med. Fakultät, Albert-Ludwigs-Universität, Killianstraße 5, 79106, Freiburg, Deutschland
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Hofauer B, Braumann B, Heiser C, Herzog M, Maurer JT, Plößl S, Sommer JU, Steffen A, Verse T, Stuck BA. Diagnosis and treatment of isolated snoring-open questions and areas for future research. Sleep Breath 2020; 25:1011-1017. [PMID: 32623557 PMCID: PMC8195801 DOI: 10.1007/s11325-020-02138-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/05/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVES Snoring is a common phenomenon which is generated by vibration of soft tissue of the upper airway during sleep. Due to the high incidence of isolated snoring and the substantial burden for the patient and the bed partner, a thorough examination and appropriate therapy are required. Many recommendations for the treatment of isolated snoring are either not evidence-based or are derived from recommendations for the management of obstructive sleep apnea. Therefore, the aim of this study is the identification and description of open questions in the diagnosis and treatment of isolated snoring and the illustration of areas for further research. METHODS In the context of the development of the new version of the German guideline "Diagnosis and treatment of isolated snoring in adults," a multidisciplinary team of experts performed a systematic literature search on the relevant medical data and rated the current evidence regarding the key diagnostic and therapeutic measures for snoring. RESULTS The systematic literature review identified 2293 articles. As a major inclusion criterion, only studies on primary snoring based on objective sleep medical assessment were selected. After screening and evaluation, 33 full-text articles remained for further analysis. Based on these articles, open questions and areas for future research were identified for this review. CONCLUSION Several major gaps in the literature on the diagnosis and treatment of isolated snoring were identified. For the majority of diagnostic and therapeutic measures for snoring, high-level scientific evidence is still lacking.
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Affiliation(s)
- B Hofauer
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Freiburg, Killianstr. 5, 79106, Freiburg, Germany. .,Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
| | - B Braumann
- Department of Maxillofacial Surgery/Orthodontics, University of Cologne, Cologne, Germany
| | - C Heiser
- Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - M Herzog
- Department of Otorhinolaryngology/Head and Neck Surgery, Carl-Thiem-Hospital Cottbus, Cottbus, Germany
| | - J T Maurer
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Mannheim, Mannheim, Germany
| | - S Plößl
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Halle, Halle, Germany
| | - J U Sommer
- Department of Otorhinolaryngology/Head and Neck Surgery, Helios University Hospital Wuppertal, Wuppertal, Germany
| | - A Steffen
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - T Verse
- Department of Otorhinolaryngology/Head and Neck Surgery, Asklepios Hospital Hamburg Harburg, Hamburg, Germany
| | - B A Stuck
- Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Marburg, Philipps-Universit Marburg, Marburg, Germany
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Hofauer B, Heiser C, Offergeld C. Vorbereitung zur Facharztprüfung HNO. HNO 2020; 68:126-130. [DOI: 10.1007/s00106-020-00818-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Heiser C, Strassen U, Knopf A, Leuchten Y, Hofauer B. Schlafpositionstrainer zur Behandlung der rückenlagebezogenen obstruktiven Schlafapnoe. HNO 2019; 67:663-669. [DOI: 10.1007/s00106-019-0697-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Standard treatment of obstructive sleep apnea (OSA) is nightly application of positive airway pressure therapy (CPAP). However, adherence to CPAP is limited due to side effects and complications, and patients are frequently untreated or undertreated. In this scenario, patients with OSA are at risk of developing comorbidities such as arterial hypertension, coronary artery disease, or diabetes, and are exposed to an increased risk of experiencing traffic or occupational accidents due to daytime sleepiness. Alternative treatments include mandibular advancement devices or positional devices to prevent patients sleeping on their back, as well as anatomy-altering surgical procedures. For several years now, an additional surgical treatment-hypoglossal nerve stimulation-has been available for selected OSA patients. Hypoglossal nerve stimulation is a dynamic surgical approach that uses electrical stimulation to activate key muscles of the upper airway to achieve airway patency.
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Affiliation(s)
- C Heiser
- Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - B Hofauer
- Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland
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Abstract
Manifestations of autoimmune disorders represent a diagnostic challenge. Many autoimmune disorders show typical manifestations in the ear, nose and throat and should be taken into account in the differential diagnosis. Sjogren's syndrome, various vasculitides and sarcoidosis represent the most common autoimmune disorders in otorhinolaryngology, but IgG4-related diseases, relapsing polychondritis and autoimmune disorders of the mucosa are also observed. Autoimmune diseases can lead to sensorineural deficits. Both hypo- and hyperthyroidism can be caused by autoimmune disorders. The diagnosis is usually based on the corresponding classification criteria, whose correct application can facilitate the clarification of these diseases.
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Affiliation(s)
- B Hofauer
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland.
| | - A Chaker
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
| | - K Thürmel
- Rheumatologie, II. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - A Knopf
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
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Abstract
BACKGROUND In recent years, new key factors in the genesis of obstructive sleep apnea (OSA) have been described. This has led to investigation of individualized therapeutic approaches in sleep medicine. The aim of the current study is assessment of the upper respiratory tract by sonographic measurement of various anatomic landmarks. MATERIALS AND METHODS Patients with rhonchopathy as well as OSA of different severity were included and compared to healthy volunteers. All patients underwent polygraphy for assessment of nocturnal respiratory disorders. Different landmarks were defined (extension of the tongue, thickness of the pharynx, hyoid bone-thyroid cartilage distance, extension of the geniohyoid muscle) which should be measured sonographically. RESULTS A total of 155 patients were enrolled and assigned to one of five groups (control; rhonchopathy; mild, moderate, and severe OSA). There were significant differences in the parameters for measuring tongue size, the distance between the hyoid bone and thyroid cartilage, and the thickness of the pharynx between the groups. CONCLUSION As part of this sonographic assessment of the upper respiratory tract, landmarks could be identified in patients with OSA that correlated with the severity of the disease.
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Affiliation(s)
- B Hofauer
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland. .,Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland.
| | - A Knopf
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Karl
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
| | - C Heiser
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland
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Hasselbacher K, Hofauer B, Maurer JT, Heiser C, Steffen A, Sommer JU. Patient-reported outcome: results of the multicenter German post-market study. Eur Arch Otorhinolaryngol 2018; 275:1913-1919. [DOI: 10.1007/s00405-018-5017-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/24/2018] [Indexed: 01/28/2023]
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Heiser C, Wirth M, Hofauer B. 0511 Upper Airway Stimulation For Obstructive Sleep Apnea: A Single Center Clinical Experience With 100 Patients. Sleep 2018. [DOI: 10.1093/sleep/zsy061.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Heiser
- Technical University of Munich, Munich, GERMANY
| | - M Wirth
- Technical University of Munich, Munich, GERMANY
| | - B Hofauer
- Technical University of Munich, Munich, GERMANY
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Philip P, Heiser C, Bioulac S, Altena E, Penchet G, Cuny E, Hofauer B, Monteyrol P, Micoulaud-Franchi J. 0513 Effects of Hypoglossal Nerve Stimulation on Sleep Architecture and Objective Level of Alertness measured by MWT in OSA Patients. Sleep 2018. [DOI: 10.1093/sleep/zsy061.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - C Heiser
- Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Hals-Nasen-Ohren-Klinik, Ismaninger Straße 22, Muenchen, GERMANY
| | | | | | - G Penchet
- Service de Neuro-chirurgie, CHU de Bordeaux, Bordeaux, FRANCE
| | - E Cuny
- Service de Neuro-chirurgie, CHU de Bordeaux, Bordeaux, FRANCE
| | - B Hofauer
- Department of Otolaryngology, Head and Neck Surgery, Technical University of Munich, Klinikum rechts der Isar, Hals-Nasen-Ohren-Klinik, Ismaninger Straße 22, Muenchen, GERMANY
| | - P Monteyrol
- Clinique du sommeil, CHU de Bordeaux, Bordeaux, FRANCE
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Philip P, Heiser C, Bioulac S, Altena E, Penchet G, Cuny E, Hofauer B, Monteyrol PJ, Micoulaud Franchi JA. Evolution of sleep architecture and level of alertness measured by MWT in apneic patients treated by genioglossus stimulation (inspire ® therapy). Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hofauer B, Steffen A, Knopf A, Heiser C. Adherence to upper-airway stimulation in the treatment of obstructive sleep apnea. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hofauer B, Heiser C. 0569 EFFECTS OF UPPER-AIRWAY STIMULATION ON SLEEP ARCHITECTURE IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Heiser C, Maurer JT, Hofauer B, Sommer JU, Seitz A, Steffen A. 0576 SELECTIVE UPPER AIRWAY STIMULATION IN OBSTRUCTIVE SLEEP APNEA: GERMAN POST MARKET STUDY - 12 MONTHS FOLLOW-UP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Bartoloni E, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Kwok SK, Nordmark G, Suzuki Y, Giacomelli R, Devauchelle-Pensec V, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. THU0352 Worldwide Heterogeneous Diagnostic Approach To Primary Sjögren Syndrome in 8315 Patients (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hofauer B, Bas M, Mansour N, Loeffelbein D, Knopf A. SAT0289 Sonographic Alterations during The Course of Sjögren's Syndrome – A Five-Year Follow Up. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brito-Zerόn P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Mandl T, Li X, Baldini C, Gottenberg JE, Danda D, Quartuccio L, Priori R, Hernández-Molina G, Kruize A, Valim V, Kvarnstrom M, Sene D, Gerli R, Praprotnik S, Isenberg D, Solans R, Rischmueller M, Park SH, Nordmark G, Suzuki Y, Giacomelli R, Saraux A, Bombardieri M, Hofauer B, Bootsma H, Hammenfors D, Fraile G, Carsons S, Gheita T, Morel J, Vollenveider C, Atzeni F, Retamozo S, Horvath IF, Sivils K, Theander E, Sandhya P, De Vita S, Sanchez-Guerrero J, van der Heijden E, Moça-Trevisano V, Wahren-Herlenius M, Mariette X, Ramos-Casals M. SAT0287 Ethnic Differences Strongly Influence The Phenotypic Expression of Primary Sjögren: Study of 7887 Patients from 20 Countries on 5 Continents (EULAR-SS Task Force Big Data Sjögren Project). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hammenfors D, Nes P, Milic V, Delli K, Hofauer B, Baldini C, Devauchelle-Pensec V, Theander E, Brun J, Jonsson M. AB0944 Automating Evaluation of Salivary Gland Ultrasound Images in Pss Patients Using The Scattered Transform Algorithm – A Pilot Study. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Knopf A, Drecoll E, Becker K, Bas M, Mansour N, Hofauer B. AB0504 Salivary Interleukin 6 in Primary Sjoegren's Syndrome Mo. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hofauer B, Bas M, Mansour N, Knopf A. THU0002 Pathological Findings Using High END Ultrasonography in Primary SjÖGren's Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hofauer B, Bas M, Strassen U, Matsuba Y, Mansour N, Knopf A. [Liposomal local therapy of sinunasal symptoms in ANCA associated vasculitis]. Laryngorhinootologie 2014; 93:461-6. [PMID: 24777579 DOI: 10.1055/s-0034-1372588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND GPA, eGPA and MPA constitute the group of AAV. ENT manifestations are part of the typical clinical picture of these diseases. Usually, patients are treated with systemic immunomodulatory drugs, mostly based on organ affection. In clinical routine, an insufficient decrease of sinunasal manifestations during a solely systemic therapeutic concept can repeatedly be -observed. MATERIAL AND METHODS Between February 2009 and November 2012, 20 patients with AAV were diagnosed in or referred to our department for further treatment. Clinical symptoms and manifestations were measured by the use of international accepted activity scores. The effect of a local therapy with liposomes for a period of 2 months on sinunasal symptoms was prospectively evaluated by using visual analogue scales and standardized questionnaires. RESULTS Within the described collective 100% of patients did show ENT-symptoms at the time of initial diagnosis. Every patient did receive immunomodulatory therapy, but in 61.1% of cases there was just slight or no improvement on sinunasal symptoms. After a 2-month period of liposomal local therapy, a significant reduction of sinunasal complaints could be observed, both evaluated via visual analogue scales (p<0.001 to p=0.014, depending on the evaluated symptom) and standardized questionnaires (p<0.001). CONCLUSIONS The local application of liposomes in addition to a systemic therapy is effective in alleviating sinunasal manifestations in patients with AAV.
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Affiliation(s)
- B Hofauer
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - M Bas
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - U Strassen
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - Y Matsuba
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - N Mansour
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
| | - A Knopf
- Klinikum rechts der Isar, Hals-Nasen-Ohrenklinik und Poliklinik, München
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Hofauer B, Bas M, Mansour N, Knopf A. THU0269 Liposomal Local Therapy as Treatment of Sicca Symptoms in Patients with Primary SjöGren´s Syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
A 42-year-old patient presented with a 7-year history of a slowly enlarging mass in the right submandibular area, which has been growing faster for the last 6 month. Apart from that there were no other symptoms. Physical examination and a magnetic resonance imaging (MRI) scan did not identify the nature of the tumor. A resection of the mass was performed and the surgical specimen was revealed to be a mature teratoma by histology.
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Affiliation(s)
- B Hofauer
- Hals-Nasen-Ohren-Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität, Ismaninger Straße 22, 81675, München, Deutschland
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